Modelling and predicting the spatio-temporal spread of cOVID-19 in Italy.

BACKGROUND: The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was first detected in China at the end of 2019 and it has since spread in few months all over the World. Italy was one of the first Western countries who faced the health emergency and is one of the countries most severely affected by the pandemic. The diffusion of Coronavirus disease 2019 (COVID-19) in Italy has followed a peculiar spatial pattern, however the attention of the scientific community has so far focussed almost exclusively on the prediction of the evolution of the disease over time. METHODS: Official freely available data about the number of infected at the finest possible level of spatial areal aggregation (Italian provinces) are used to model the spatio-temporal distribution of COVID-19 infections at local level. An endemic-epidemic time-series mixed-effects generalized linear model for areal disease counts has been implemented to understand and predict spatio-temporal diffusion of the phenomenon. RESULTS: Three subcomponents characterize the fitted model. The first describes the transmission of the illness within provinces; the second accounts for the transmission between nearby provinces; the third is related to the evolution of the disease over time. At the local level, the provinces first concerned by containment measures are those that are not affected by the effects of spatial neighbours. On the other hand, the component accounting for the spatial interaction with surrounding areas is prevalent for provinces that are strongly involved by contagions. Moreover, the proposed model provides good forecasts for the number of infections at local level while controlling for delayed reporting. CONCLUSIONS: A strong evidence is found that strict control measures implemented in some provinces efficiently break contagions and limit the spread to nearby areas. While containment policies may potentially be more effective if planned considering the peculiarities of local territories, the effective and homogeneous enforcement of control measures at national level is needed to prevent the disease control being delayed or missed as a whole. This may also apply at international level where, as it is for the European Union or the United States, the internal border checks among states have largely been abolished.

Assessing the effect of containment measures on the spatio-temporal dynamic of COVID-19 in Italy.

This paper aims at investigating empirically whether and to what extent the containment measures adopted in Italy had an impact in reducing the diffusion of the COVID-19 disease across provinces. For this purpose, we extend the multivariate time-series model for infection counts proposed in Paul and Held (Stat Med 30(10):118-1136, 2011) by augmenting the model specification with B-spline regressors in order to account for complex nonlinear spatio-temporal dynamics in the propagation of the disease. The results of the model estimated on the time series of the number of infections for the Italian provinces show that the containment measures, despite being globally effective in reducing both the spread of contagion and its self-sustaining dynamics, have had nonlinear impacts across provinces. The impact has been relatively stronger in the northern local areas, where the disease occurred earlier and with a greater incidence. This evidence may be explained by the shared popular belief that the contagion was not a close-to-home problem but rather restricted to a few distant northern areas, which, in turn, might have led individuals to adhere less strictly to containment measures and lockdown rules.

The polarizing impact of numeracy, economic literacy, and science literacy on the perception of immigration.

Immigrants might be perceived as a threat to a country's jobs, security, and cultural identity. In this study, we aimed to test whether individuals with higher numerical, scientific, and economic literacy were more polarized in their perception of immigration, depending on their cultural worldview orientation. We measured these variables in a representative sample of citizens in a medium-sized city in northern Italy. We found evidence that numerical, scientific, and economic literacy polarize concerns about immigration aligning them to people's worldview orientations. Individuals with higher numerical, economic, and scientific literacy were less concerned about immigration if they held an egalitarian-communitarian worldview, while they were more concerned about immigration if they held a hierarchical-individualistic worldview. On the contrary, individuals with less numerical, economic, and scientific literacy did not show a polarized perception of immigration. Results reveal that citizens with higher knowledge and ability presented a more polarized perception of immigration. Conclusions highlight the central role of cultural worldviews over information theories in shaping concerns about immigration.

EEG findings in cooled asphyxiated newborns and correlation with site and severity of brain damage.

OBJECTIVE: EEG and MRI are useful tools to evaluate the severity of brain damage and to provide prognostic indications in asphyxiated neonates. Aim of our study is to analyze the relationship between serial neonatal EEGs and severity and sites of brain lesions on MRI in neonates undergoing hypothermia, following a hypoxic-ischemic injury. PATIENTS AND METHODS: Forty-eight term newborns underwent hypothermia. Serial videoEEG recordings were taken at 6, 24, 48 and 72 h and during 2nd week of life. Brain MRI was performed at the end of 2nd postnatal week and correlated with EEG. RESULTS: EEGs improved during the first days. At the first recording 25 infants showed a severe or very low amplitude EEG pattern while at the 2nd week only 7 showed such patterns. As regards MRI, 21 infants showed a predominant Basal Ganglia and Thalami damage, 4 infants showed a predominant focal Thalami lesion and 23 showed normal imaging or just mild White Matter abnormalities. Severity of EEG pattern was associated with the odds of having MRI lesions at Basal Ganglia, Thalami, White Matter, Internal Capsule, but not at Cortex. Infants who showed only mild EEG abnormalities in the first 2 days had no Basal Ganglia and Thalami MRI lesion. The persistence of a discontinuous EEG at the 2nd week recording is always associated with Basal Ganglia and Thalami damage. CONCLUSION: The severity of EEG background is associated with severity and site of MRI lesion pattern in neonates treated with hypothermia because of hypoxic-ischemic encephalopathy.

Poor repertoire General Movements predict some aspects of development outcome at 2 years in very preterm infants.

BACKGROUND: Observation of the quality of endogenously generated "General Movements" has been proved to be a reliable and sensitive tool in the assessment of fragile neonates. The absence of fidgety movements at 2-4 months post-term is highly predictive of Cerebral Palsy. On the contrary, the presence of a poor repertoire pattern during the writhing period is not reliable in predicting motor or neurobehavioral disorders at any stage of development. AIM: To examine if the presence of a PR pattern at 1 month post-term was associated with lower neurodevelopmental quotients at 2 years. STUDY DESIGN: General Movements evaluation at 1 and 3 months and the Griffiths Scales of Mental Development at 2 years were administered to a sample of very preterm infants. Infants were divided into two groups: poor repertoire pattern group and normal pattern group. Student's t Test and Chi squared test and ANOVA were used to compare neonatal variables and results between the two groups. SUBJECTS: 79 very preterm infants (birthweight≤1500 g or gestational age≤32 weeks), born January 2003 to December 2006 who had a follow-up at 2 years. OUTCOME MEASURE: Griffiths developmental quotient at 2 years. RESULTS: The Poor Repertoire group had lower Gestational Age, lower Birth Weight, lower Apgar scores at birth and lower Developmental Quotient at 2 years. Eye and Hand Coordination (subscale D) was the domain mostly responsible for such a difference. Quality of fidgety movements (normal or abnormal fidgety) at 3 months did not show any correlation with outcome measures at 2 years. CONCLUSION: The presence of a PR pattern at 1 month post-term seems to predict lower neurodevelopmental scores at 2 years especially in the domain of eye and hand coordination. Longer follow-up is necessary in order to ascertain if such difference will continue to persist at older ages.